Specimen Adequacy and Safety of Percutaneous Ultrasound-Guided Native Kidney Biopsies Performed by Short-Term Trained Nephrology Fellows

Korean Journal of Nephrology 2010;29(2):215-223.

Hyeon Seok Hwang, M.D., So Young Lee, M.D., Seok Hui Kang, M.D., Byung Ha Jung, M.D., Bok Jin Hyoung, M.D., Youn Joo Jeon, M.D., Bum Soon Choi, M.D., Cheol Whee Park, M.D., Chul Woo Yang, M.D. and Yongsoo Kim, M.D.

Division of Nephrology, Departments of Internal Medicine The Catholic University of Korea School of Medicine, Seoul, Korea

원저 : 단기간 교육을 받은 신장내과의사가 시행한 경피적 초음파 유도 신장조직검사의 검체 적절성과 안전성

황현석, 이소영, 강석휘, 정병하, 형복진, 전연주, 최범순, 박철휘, 양철우, 김용수

가톨릭대학교 의과대학 내과학교실

Abstract

Purpose : Specimen adequacy and safety of percutaneous ultrasound-guided native kidney biopsies performed by short-term trained nephrology fellows were evaluated. Methods : The differences in specimen adequacy and safety between nephrology fellow-performed (NP, n=67) and radiologist-performed (RP, n=82) percutaneous ultrasound-guided native kidney biopsies were retrospectively evaluated. Results : The mean age of the patients was 35±15 years old, and the M:F ratio was 1.2:1. There were no differences in age, sex, anemia, platelet count and glomerular filtration rate between NP and RP patients. The mean glomerular count was 15.9±8.4 in light microscopy and 9.9±7.2 in immunofluorescent microscopy. Ninety five percent of biopsy specimens were adequate for pathological diagnosis. Between NP and RP kidney biopsies, there were no differences in the glomerular count in light and immunofluorescent microscopy, percentage of presence of glomeruli in electron microscopy, and the specimen adequacy for the pathological diagnosis. The rates of major and minor complications were 1.5% and 6%, respectively, in NP kidney biopsies. On the other hand, the rate of major complications was 9.8% in RP kidney biopsies, which was significantly higher than that in NP kidney biopsies. The rate of decrease in hemoglobin and hematocrit levels after biopsies was significantly higher in RP biopsies than in NP biopsies. Conclusion : Short-term trained nephrology fellows perform percutaneous ultrasound-guided kidney biopsy at a level equal to or superior to radiologists.

Key Words: Kidney, Biopsy, Ultrasonography